Provider Demographics
NPI:1598861437
Name:PALAZZO-MEMOLI, ANN C (RPH,MS)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:C
Last Name:PALAZZO-MEMOLI
Suffix:
Gender:F
Credentials:RPH,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17972 DUMFRIES CIR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1647
Mailing Address - Country:US
Mailing Address - Phone:301-774-1807
Mailing Address - Fax:
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:PHARMACY SERVICE (119)
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7450
Practice Address - Fax:410-605-7852
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16570183500000X
NY032668-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist